The health benefits of regular physical exercise are well known. The benefits include but are not limited to improved cardiovascular health. However, motivation to engage is such a program is frequently lacking in a sizable percentage of the population. Pharmacological or drug therapies, e.g., statins, have been shown to marginally improve cardiovascular health. However, there may be detrimental side effects. Further, such drug regimens have been shown less effective than regular exercise. Further, it is known that cardiovascular disease may be caused and/or enhanced by an impairment of tissue perfusion. Cardiovascular health is a function of the health of the endothelium. The endothelium is directly benefited by devices and method taught by this disclosure.
However, even other noninvasive lifestyle approaches to chronic disease management can be tempered with side effects and ineffectiveness. For example, regular exercise is known to lower blood pressure in healthy individuals by inducing ischemia. Inducing ischemia by exercise may, however, also be problematic because it causes an increase in heart rate that may not be tolerated well by some individuals. Further, exercise, diet, and weight loss programs are all well known to suffer problems of compliance.
The endothelium has many important functions in maintaining the patency and integrity of the arterial system. The endothelium can reduce and inactivate toxic super-oxides which may be present in diabetics and in smokers. The endothelium is the source of nitric oxide, a local hormone that relaxes the adjacent smooth muscle cells in the media, and is a powerful vasodilator.
The endothelium regulates vascular homeostasis by elaborating a variety of paracrine factors that act locally in the blood vessel wall and lumen. Under normal conditions, these aspects of the endothelium, hereinafter referred to as “endothelial factors”, maintain normal vascular tone, blood fluidity, and limit vascular inflammation and smooth muscle cell proliferation.
Arm cuff inflation provides a suprasystolic pressure stimulus. Ischemia reduces distal resistance and opening the cuff induces stretch in the artery. Imaging of the diameter of the artery with high resolution ultrasound along with measuring the peak flow defines endothelial function. However, this method requires very sophisticated equipment and operators that are only available in a few specialized laboratories worldwide.
A separate therapy for cardiovascular health is enhanced external counterpulsation therapy. This therapy requires monitoring and coordination with the cycle of the heartbeat. This therapy involves the propulsion of blood into the subject's torso during the diastole phase of the cycle. The movement of blood increases the shear stress on the arterial walls including endothelium. This is equivalent to the high shear stress achieved during exercise. This event is beneficial to the endothelium.
What is needed is a non-invasive and inexpensive physical conditioning treatment therapy or combination of therapies that reproduce or enhance the physiological effects of exercise.